Organization
RIVERSIDE EYE, EAR, NOSE,THROAT INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN J. ALLAVIE MD (PRESIDENT)
(951) 686-4911
Entity
Organization
Contact information
Practice address
4500 BROCKTON AVE, L05, RIVERSIDE, CA 92501-4090
(951) 788-2788
Mailing address
4500 BROCKTON AVE, L05, RIVERSIDE, CA 92501-4090
(951) 788-2788
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
250000356
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
SUR51087F
—
CA
Enumeration date
09/12/2006
Last updated
01/24/2013
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